Tool Helps Donor-Assisted Families Discuss Origins & Improve Transparency

For families built through donor-assisted reproduction, the intention to be open with children about their origins is often strong. Yet, many find themselves years down the line, still grappling with how to begin that conversation. A fresh digital resource, the TELL Tool – short for Tool to Empower Parental Telling and Talking – aims to bridge that gap, offering support to parents navigating these sensitive discussions with children aged one to sixteen.

Developed by Patricia Hershberger, a professor at the University of Michigan School of Nursing, and her team, the TELL Tool isn’t a one-size-fits-all script, but rather a suite of interactive modules designed to build parental confidence. The tool emerged from a twelve-year longitudinal study tracking families who utilized donor gametes, revealing that only around 14% of parents actually disclosed their child’s origins during their children’s middle childhood.

A Shift in Perspective

Historically, secrecy surrounding conception origins was common, even encouraged within the clinical community. But, a growing consensus now favors transparency, a shift accelerated by the rise of direct-to-consumer DNA testing services. These kits, while offering intriguing insights into ancestry, can also unexpectedly reveal biological connections, prompting hard conversations and highlighting the importance of genetic health literacy.

The TELL Tool addresses this evolving landscape by providing parents with practical tools and strategies. One module features fourteen real-world scenarios, ranging from answering a child’s questions about their donor to managing the privacy of this information. For each scenario, the tool offers guidance designed to bolster parental confidence during these potentially fraught conversations.

Building Confidence and Facilitating Disclosure

Recent research demonstrates the tool’s effectiveness. A 2025 randomized controlled trial, published in the Journal of Pediatric Health Care, showed that parents who used the TELL Tool reported increased confidence and competence, alongside decreased anxiety, over a twelve-week period. More significantly, 77% of parents utilizing the TELL Tool video modules chose to disclose their child’s conception origins, compared to just 54% in a control group using a standard e-book, and a mere 14% in the original longitudinal study sample.

One study participant succinctly captured the tool’s value, stating, “The content is very important and very complete. Integrating children and real scenarios helps the audience connect.”

Expanding Support to Clinicians and New Parents

The research team is now focused on expanding the TELL Tool’s reach, developing a new iteration to support expectant and new parents, as well as the clinicians who care for them. This expansion was informed by interviews with both parents and healthcare providers, revealing a critical gap: while parents overwhelmingly intend to be transparent with their children, clinicians often sense ill-equipped to provide adequate support.

Many parents reported that no healthcare professional had ever initiated a conversation about disclosing their child’s origins. Clinicians, cited time constraints and a lack of specific training as barriers to addressing this sensitive topic. This disconnect underscores the require for resources that empower both parents and healthcare providers to navigate these complex discussions.

Parents also voiced anxieties surrounding disclosure, including fears of rejection and shame. One parent expressed a deep concern about their child’s acceptance, stating, “Her, you know, accepting what I did. And not finding fault in it at the end of the day is my greatest fear.” Conflicts with partners regarding the timing of disclosure were also frequently mentioned.

Addressing Clinician Capacity and Parental Needs

The newest version of the TELL Tool aims to address these challenges by incorporating clinician feedback and providing targeted support for expectant and new parents. Mary Richardson, project director and research specialist, emphasizes the potential impact: “This will make a massive difference for donor-assisted families by helping parents navigate conversations and by supporting their child’s health as they grow. It will also support health care providers by bridging gaps in information, which is central when helping families navigate this journey.”

A recent study published in JMIR Formative Research details the development of this expanded tool, highlighting the qualitative research that informed its design. The researchers found that while parents are motivated to be open with their children, they often lack the tools and confidence to do so effectively.

Looking Ahead: Further Research and Wider Availability

The team is currently using data from the JMIR Formative Research study to refine and test the new TELL Tool with pregnant and new parents, and with clinicians. They have also applied for a National Institutes of Health (NIH) grant to fund a larger randomized controlled trial, a crucial step toward making the TELL Tool widely accessible to families.

Patricia Hershberger underscores the importance of open communication, stating, “Our evidence to date, and what donor-conceived people have said, indicates that the health of parents, their children, and the relationships between parents and children, are better when parents tell their children about how they came to be. However, what we don’t know yet are ‘healthy’ ways to have parents tell children versus ways that cause harm. My team and I hope to uncover these components.”

The ongoing research seeks to identify best practices for these conversations, ultimately aiming to foster healthier family dynamics and support the well-being of all involved. The TELL Tool represents a significant step forward in providing the resources and support needed for donor-assisted families to navigate these sensitive and important discussions.

More information:

Patricia E Hershberger et al, Expanding the Digital, Donor-Assisted Conception Tool to Empower Parental Telling and Talking (TELL Tool) Intervention to the Pregnant and Early Parenthood Periods: Findings From a Qualitative Study, JMIR Formative Research (2026). DOI: 10.2196/79024

Patricia E. Hershberger et al, A Randomized Pilot Trial of the Donor Conception Tool to Empower Parental Telling and Talking (TELL Tool) with Their Children About Their Genetic Origins, Journal of Pediatric Health Care (2025). DOI: 10.1016/j.pedhc.2024.06.006